title: The validity of self-rated psychotic symptoms in depressed inpatients.
abstract: BACKGROUND
  Self-ratings of psychotic experiences might be biased by depressive symptoms.
  
  
  METHODS
  Data from a large naturalistic multicentre trial on depressed inpatients (n=488) who were assessed on a biweekly basis until discharge were analyzed. Self-rated psychotic symptoms as assessed with the 90-Item Symptom Checklist (SCL-90) were correlated with the SCL-90 total score, the SCL-90 depression score, the Beck Depression Inventory (BDI), the Hamilton Depression Rating Scale 21 item (HAMD-21) total score, the Montgomery Åsberg Depression Rating Scale (MADRS) total score and the clinician-rated paranoid-hallucinatory score of the Association for Methodology and Documentation in Psychiatry (AMDP) scale.
  
  
  RESULTS
  At discharge the SCL-90 psychosis score correlated highest with the SCL-90 depression score (0.78, P<0.001) and with the BDI total score (0.64, P<0.001). Moderate correlations were found for the MADRS (0.34, P<0.001), HAMD (0.37, P<0.001) and AMDP depression score (0.33, P<0.001). Only a weak correlation was found between the SCL-90 psychosis score and the AMDP paranoid-hallucinatory syndrome score (0.15, P<0.001). Linear regression showed that change in self-rated psychotic symptoms over the treatment course was best explained by a change in the SCL-90 depression score (P<0.001). The change in clinician-rated AMDP paranoid-hallucinatory score had lesser influence (P=0.02).
  
  
  CONCLUSIONS
  In depressed patients self-rated psychotic symptoms correlate poorly with clinician-rated psychotic symptoms. Caution is warranted when interpreting results from epidemiological surveys using self-rated psychotic symptom questionnaires as indicators of psychotic symptoms. Depressive symptoms which are highly prevalent in the general population might influence such self-ratings.
authors.affiliation: Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Nussbaumstrasse 7, 80336 Munich, Germany. florian.seemueller@med.uni-muenchen.de
authors.forename: F
authors.initials: F
authors.lastname: Seemüller
authors.forename: M
authors.initials: M
authors.lastname: Riedel
authors.forename: M
authors.initials: M
authors.lastname: Obermeier
authors.forename: R
authors.initials: R
authors.lastname: Schennach-Wolff
authors.forename: I
authors.initials: I
authors.lastname: Spellmann
authors.forename: S
authors.initials: S
authors.lastname: Meyer
authors.forename: M
authors.initials: M
authors.lastname: Bauer
authors.forename: M
authors.initials: M
authors.lastname: Adli
authors.forename: K
authors.initials: K
authors.lastname: Kronmüller
authors.forename: M
authors.initials: M
authors.lastname: Ising
authors.forename: P
authors.initials: P
authors.lastname: Brieger
authors.forename: G
authors.initials: G
authors.lastname: Laux
authors.forename: W
authors.initials: W
authors.lastname: Bender
authors.forename: I
authors.initials: I
authors.lastname: Heuser
authors.forename: J
authors.initials: J
authors.lastname: Zeiler
authors.forename: W
authors.initials: W
authors.lastname: Gaebel
authors.forename: H-J
authors.initials: HJ
authors.lastname: Möller
mesh_terms: D000328:Adult; D057189:Checklist; D003863:Depression / Q000150:complications* / Q000523:psychology; D003866:Depressive Disorder / Q000150:complications* / Q000523:psychology; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology